The health care system in India is divided into public sector, private sector, indigenous system of medicine and other agencies. Private practitioners (PPs) constitute nearly 70% of medical profession in India. The need for including the PPs in the National TB Programme had been felt since 1975. With a vision for TB free India we need to approach the missing 3 million cases. One of the key pillars towards achieving universal access is to ‘expand efforts to engage all care providers’. Involvement of private practitioners (PPs) in disease programmes (both communicable and non-communicable), continues to be a major challenge for the concerned health authorities. This paper focuses on the various factors and the challenges in public private mix (PPM) strategies.